Impact of prior cancer on the overall survival of patients with
osteosarcoma: A nomogram based on the SEER database
Background: This study aimed to identify the impact of prior cancer on
the overall survival (OS) of patients with osteosarcoma and to describe
their characteristics and then establish a nomogram. Procedure: Data of
patients with osteosarcoma diagnosed between 2010 and 2015 were
extracted from the Surveillance, Epidemiology, and End Results database.
The difference was balanced by propensity score matching. Kaplan–Meier
and Cox analyses were performed to evaluate the influence of prior
cancer. Patients were randomly divided into a training cohort and a
testing cohort. A nomogram for predicting 3- and 5-year OS was
established by multivariate Cox analyses. The discriminative ability and
calibration of the nomogram were assessed by C-index values and
calibration plots. Results: In total, 615 patients were identified, of
which 103 (16.74%) had prior cancer. The most frequently reported type
was breast cancer (12.62%). Patients with prior cancer possessed a
poorer OS than those without prior cancer (p =0.023). Importantly,
patients with prior bone sarcoma, breast, gastrointestinal, and
hematological cancers had a non-inferior OS. The nomogram demonstrated
favorable discriminatory ability as indicated by the C-index (0.728).
Calibration plots indicated optimal agreement between the
nomogram-predicted survival and the actual observed survival.
Conclusions: This is the first study to report that osteosarcoma
patients with prior cancer have a poor OS and provide a novel prognostic
nomogram based on prior cancer history. Different prior cancer types had
various effects on the OS. The nomogram facilitated individual prognosis
prediction and clinical decision-making.